Comorbidities. ⢠Ethnic group. Treatment. Availability. Laws. Attitudes. Page 41. It is better to know some of the questions than all of the answers. James Thurber.
What is the impact of gambling availability on gambling problems? David Hodgins AGRI, 2006
What is the impact of gambling availability on gambling problems? Three models Linear Problems
none
some
a lot
many
Gambling availability
tons
Saturation Model
Problems
none
some
a lot
many
Gambling availability
tons
Social Adaptation Model (Shaffer)
Gambling availability
to ns
m an y
lo t a
so m e
no ne
Problems
Challenges to testing the models •
Operationalizing Terms
•
Confounding Factors
Operationalizing Terms
Different ways of conceptualizing Gambling Availability /accessibility /exposure 1. Dichotomous (yes/no) Lester (1994) US states with and without casinos – # of GA groups E.g., before and after opening a casino
2. Number of different available types of gambling Volberg (1994) – cross sectional comparison of states
Shaffer’s proposed Regional Index of Gambling Exposure
Uses environmental exposure to chemical toxins as model (Shaffer et al., 2004) Three summed components
Dose (D)– quantity of gambling Potency (P)– number of types of gambling Duration (T) – years of exposure
RIGE = D + P+ T Dose (D)– quantity of gambling # of gambling establishments # of people employed in casinos and casino hotels
Potency (P)– number of types of gambling # of legal forms of gambling available (of 6)
Duration (T) – years of exposure Years of legalized gambling in state
RIGE and Gambling ProblemsNevada (adapted from Shaffer et al., 2004)
Problems with RIGE
Equal weighting of factors Inclusion of # of employees?
More validation research
Alberta 10% of household $, four times higher)
Other Research Gambling Availability
Gambling Behaviour
Gambling Problems
UK Studies – National Lottery 1994 (Shepherd et al., 1998) Resident mail questionnaire Oct-94, May-95 andNov-95 (N=206, 38%) Increase in gambling DSM symptoms; (17% increase in calls to GA)
Other Research Gambling Availability
Gambling Behaviour
Gambling Problems
Canadian Studies – opening casinos Windsor (Govoni et al., 1999) RDD survey (SOGS) 1993 (N=1682), 1995 (N=2581), 1997 (N=2714) Increase in number gambling after 4 years, but not number of problem gamblers
Canadian Studies – casinos Gambling Availability
Gambling Behaviour
Gambling Problems
Niagara (Room et al., 1999) RDD 1996 Niagara Falls residents (N=677) and followed for 1 year (69%) plus other databases short SOGS Increase in gambling, increase in problems, increase in knowing someone with problem
Canadian Studies – casinos Gambling Availability
Gambling Behaviour
Gambling Problems
Gatineau (Jacques et al., 2000) 1996 RDD in Gatineau (N= 810) and Quebec City (control, N=798) followed for one year (79% and 73%) SOGS Increase in gambling, increase in problem but not pathological gambling, increase in knowing someone with problem
Summary of Longitudinal Research
Gambling Availability
Gambling Behaviour
• All short term follow-ups • Future studies?
Gambling Problems
Laws
Gambling Availability
Attitudes
Gambling Behaviour
Treatment Availability
Gambling Problems
Vulnerability Factors • Age • SES • Comorbidities • Ethnic group
Treatment Seeking
It is better to know some of the questions than all of the answers James Thurber